Superselective embolization of glomus jugulare tumors.

The purpose of this report is to introduce the technique of superselective embolization (SSE) and to review our experience in surgically treating glomus jugulare tumors with and without preoperative SSE. Retrospective chart review was performed to determine estimated blood loss and operative time, and illustrative case reports are presented. The technique of preoperative SSE represents an important advance in the surgical management of glomus jugulare tumors. In our experience, surgical ligation of tumor-feeding vessels or nonselective embolization of the external carotid system is unsatisfactory. Inadequate devascularization and excessive risk of complications have caused us and others to abandon these procedures. However, SSE performed by an experienced neuroradiologist can produce effective and safer tumor devascularization. Preoperative SSE results in shrinkage of tumor size and significantly decreases blood loss. The advantages to the surgeon include improved visualization and ease of dissection as well as increased confidence that complete tumor excision has been achieved.